techtalk ce

An educational service for Canadian pharmacy technicians, brought to you by Teva.

Learning objectivesAfter completing this lesson, the pharmacy technician participant will be able to:1. Review four dermatological conditions (acne, eczema, psoriasis, rosacea) and their

available treatments. 2. Discuss the importance of adherence to medication therapy. 3. Review potential concerns with these conditions being left untreated.4. Understand how a registered pharmacy technician can assist patients in managing

these conditions.

A Primer on Dermatology

• C o n t i n u i n g E d u c a t i o n •

CE JUST FOR TECHNICIANS Tech Talk CE is the only national continuing education program for Canadian pharmacy technicians.

As the role of the technician expands, use Tech Talk CE as a regular part of your learning portfolio. Note that a passing grade of 70% is required to earn the CE credit.

Tech Talk CE is generously sponsored by Teva. Download back issues at www.CanadianHealthcareNetwork.ca. The author has no competing interests to declare.

INSTRUCTIONS1. After carefully reading this lesson, go to eCortex.ca to complete the questions.

2.Answer the test online at eCortex.ca. To pass, a grade of at least 70% (11 out of 15) is required. 

3. Complete the required feedback for this lesson online at eCortex.ca.

CE FACULTY

CE Coordinator:Rosalind Stefanac

Clinical Editor:Lu-Ann Murdoch, BScPhm

Author: Robin Andrade, R.Ph.T 

THE NATIONAL CONTINUING EDUCATION PROGRAM FOR PHARMACY TECHNICIANS 1.25 CE Units

APPROVED FOR 1.25 CE Units

Approved for 1.25 CE units by the Canadian Council on Continuing Education in Pharmacy. File no. 1329-2020-2980-I-T. Please consult this course online at eCortex.ca for expiry dates.

by Robin Andrade, R.Ph.T 

Answer this CE online for instantresults and accreditation. VisiteCortex.ca

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Introduction Skin conditions such as acne, eczema, psoria-sis and rosacea can have a significant impact on a patient’s quality of life. Not only can these conditions be physically uncomfortable, but they can also affect social lives, cause embar-rassment, and potentially, isolation. With ongo-ing support from the pharmacy team, these

conditions can be successfully managed by the patient, providing a better sense of overall wellbeing.

AcneAcne vulgaris is an inflammatory disease which can be caused by multiple factors. It is the most common skin condition seen by der-

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matologists,(1) with a prevalence of 85% among those aged 12 to 24 years.(2) Characteristics of acne include:(2)

• Comedones, which may be open (black-head) or closed (whitehead)

• Papules small, tender, raised, solid pimple • Pustules (pimple containing pus) • Redness• Swelling • Scarring

Acne can affect, but is not limited to, the face, back, shoulders and neck.

Causes of Acne Acne may be caused by a bacterium called Cutibacterium acnes (C. acnes), which pro-duces pore blockage and inflammation(1), as well as increased sebum (an oily sub-stance) production by sebaceous (oil) glands. When pores become clogged with sebum and dead skin cells, acne results. Hormones, genetics, food allergies, stress and the use of cosmetics may also contrib-ute to the development of acne. Acne is classified from mild to severe according to

number of acne lesions, including comedo-nes, papules and pustules.(3)

TreatmentControl of acne requires ongoing care. Treatment is pharmacologically based, and focuses on prevention of new lesions, as well as clearing current acne. It is important to let the patient know that sometimes improvement can take two to three months,(3) and some acne medications can initially cause dryness, peeling, flaking, redness, irritation and/or pos-sibly acne flare-ups. In other words, acne can appear worse before getting better. These effects can lead some patients to stop treat-ment early. Left untreated, physical scarring on the face and body can occur, potentially causing a lifetime of negative psychological effects for the patient.

Non-Prescription Acne TreatmentThere are various medicated soaps and non-prescription washes to assist with mild acne. Products containing active ingredi-ents such as salicylic acid, sulfur and ben-

zoyl peroxide (alone or in combination) are available for patient self-care use. Although research on the effectiveness of medicated cleansers is limited, one study found these to be effective in reducing inflammatory and non-inflammatory lesions.(4)

When medicated soaps are not appro-priate or desired, patients should wash no more than twice daily with a mild soap or soapless cleanser.(5) Patients with acne may wash too frequently, attempting to remove surface oils; however, there is no

TABLE 1 - Types of Acne(1,3)

TABLE 2 - Pharmacological Treatments for Acne According to Severity(3)

Type Characteristics

Mild A few small lesions that are close to skin surface; may be inflamed. Some papules and pustules.

Moderate Somewhat larger and more extensive number of whiteheads/blackheads and inflamed spots with redness. Several papules and pustules.

Severe Involves many more acne spots, some deeper lumps called nodules and cysts, redness and scarring. Numerous papules and pustules.

Acne Severity Examples of Initial Therapies Used

Mild acne • Topical benzoyl peroxide 2.5%–10%• Topical retinoids (tretinoin, tazarotene, adapalene)• Topical combination therapy:

- Benzoyl peroxide + topical retinoid OR topical antibiotic (clindamycin, erythromycin)

- Topical retinoid + topical antibiotic

Moderate acne • Topical therapy (see mild acne, excluding topical antibiotics) + oral antibiotics (erythromycin, doxycycline, minocycline, others)

• For females: topical therapy + combined oral contraceptives (ethinyl estradiol/cyproterone, ethinyl estradiol/drospirenone, ethinyl estradiol/levonorgestrel, others) OR spironolactone

Severe acne • Oral isotretinoin• Topical therapy (see mild acne, excluding topical antibiotics) + oral

antibiotics• For females: topical therapy + combined oral contraceptives OR

spironolactone

Images of AcneAcne can affect, but is not limited to, the face, back, shoulders and neck. (https://dermatology.ca/public-patients/skin/acne/)

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evidence to suggest this improves acne.(23) To prevent acne caused by cosmetic prod-

ucts, patients should be advised to discon-tinue oil-containing cosmetics, moisturizers and sunscreens and to avoid cosmetic pro-grams that advocate applying multiple layers of cream-based cleansers and cover-ups.(23)

EczemaEczema, or atopic dermatitis (AD), is a com-mon inflammatory skin condition that affects up to 17% of Canadians at some point in their lives.(5) This condition is characterized by a dry, scaly rash with inflamed skin that is very itchy or sometimes painful.(5) Eczema tends to appear in early childhood, with patches of erythema (redness), inflammation and dryness.(5) While eczema may regress as children grow, years of uncomfortable pruritus (itching) can cause stress on the patient. The extent of eczema can vary from limited to covering most of the body, with the latter being considered severe or com-plicated eczema. The location of eczema also varies, generally with age, but is most commonly found on the face, elbows and knees of babies, and behind the knees, inside the elbows, on the sides of the neck, and on the wrists, ankles and hands of older children.(5)

Causes of EczemaEczema is often hereditary,(5) and patients can be affected at any age, although it is predominantly a disease of childhood.(7) Several factors can aggravate eczema or cause disease flares, including stress, envi-ronmental allergens, climate, and dietary influences.(7) Eczema in adults may be associated with other serious chronic con-ditions that contribute to poor health including diabetes, obesity, autoimmune disease, high blood pressure and heart disease. Risk for these conditions increases with eczema severity.(9)

Treatment Failure to follow treatment recommenda-tions is the most significant barrier to suc-cessful management of eczema, with only about 24% of patients properly following treatment recommendations.(5) Eczema is a chronic condition with no known cure. Treating symptoms, such as pruritus and dry skin, is key to patient comfort. If left untreated, eczema may become extremely uncomfortable or secondarily infected.(6)

Nonpharmacologic therapyMany nonpharmacological treatments are available for eczema. Effectiveness may

vary depending on severity of symptoms. • Bathing may be useful in rehydrating the

skin and removing irritants and allergens. Water should be warm, and the bath brief, limited to five to 10 minutes once daily. Skin should be patted dry and moisturizer should be applied within three minutes to minimize the potential drying effects of bathing.(10)

• The Canadian Dermatological Association and National Eczema Association suggest that soaking in

TABLE 4 - Pharmacological Treatments for Eczema(6, 7) Images of Eczema

(Dr. P. Marazzi/Science Photo Library)

(nationaleczema.org)

(istockphoto)

Class/ Dosage form

Examples Comments

Moisturizers • Petrolatum (occlusive moisturizer)

• Ceramides/cholesterol/free fatty acids (barrier repair product)

First-line therapy for mild eczema and an important part of treatment for moderate and severe eczema. Frequent use helps seal in moisture. Shown to prolong time to flare and reduce number of flares.(7) Patients with eczema require ongoing moisturizer therapy.

Corticosteroids (topical), various potencies

• Hydrocortisone, tri-amcinolone acetonide, beclomethasone dipropionate

Also considered first-line for management of eczema

Antibiotic/corticosteroid (topical) combinations

• Gentamicin /betamethasone valerate

• Fusidic acid/hydrocortisone

Reserved for eczema that is secondarily infected

Calcineurin inhibitors (topical)

• Pimecrolimus• Tacrolimus

Biologic therapy (subcutaneous injection)

• Dupilumab For patients who have not responded to topical treatment or those who are unable to tolerate topical therapy.

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bleach baths (a full tub of lukewarm water with a half-cup of household bleach added) for five to 10 minutes twice weekly may be effective in those suscep-tible to frequent infections,(8) which can worsen eczema.(9) However, there is con-flicting evidence regarding the effective-ness of bleach baths vs. water baths.(24) Patients should determine what works best for their eczema.

• Cool compresses relieve inflammation and itching.(5)

• Phototherapy. In those with severe eczema who have failed on topical ther-apy, regular exposure to specific rays of ultraviolet light may be effective in reduc-ing symptoms.(5,11) This treatment should only be done under the supervision of a dermatologist.

PsoriasisPsoriasis is a chronic, inflammatory, skin condition, which affects approximately one million Canadians.(12) It often appears between the ages of 15-25 and both men and women are equally susceptible.(13) There are five types of psoriasis–the two most common are reviewed in Table 5. Psoriasis can have a significant impact on a patient’s quality of life, as multiple body areas can be affected, from the soles of their feet to their face and scalp. Psoriatic arthritis is a form of chronic arthritis that may affect up to one-third of patients with psoriasis, further impairing quality of life.(13)

Causes of PsoriasisThe exact cause of psoriasis has not been determined, but researchers believe it involves a combination of environmental and immune factors, and genetics.(12) One-third of sufferers have at least one family member with the condition.(12) Psoriasis develops when there is a malfunctioning of the immune system which causes inflam-mation. White blood cells (T cells) in the immune system are triggered, causing inflammation, which leads to skin cell shed-ding at 10 times the normal rate.(12)

Common Comorbidities Patients with psoriasis may be at an increased risk of developing other chronic and serious health conditions. Left undiag-nosed and untreated, these conditions can

have negative implications for health and wellbeing. As such, patients with psoriasis should be regularly screened for potential comorbidities, including:(14) • Cancer• Cardiovascular disease• Crohn’s disease • Depression• Diabetes• Obesity• Osteoporosis• Uveitis (inflammatory disease of the eye)• Liver disease

Triggers Scientists believe that at least 10% of people inherit one or more genes that could lead to psoriasis. However, only 2%–3%(15) of the population actually develops the disease. This may be because patients must not only have the genes that cause psoriasis, but also be exposed to certain triggers. These trig-gers may also be responsible for disease flare-ups. Potential triggers include:(15)

• Dry winter weather that causes the skin to become irritated and itchy.

• Stress (note: decreasing potential stress-ors can improve a patient’s quality of life. Keeping a diary of stressors can assist the patient in identifying triggers).

• Obesity or smoking cigarettes can increase psoriasis complications.

• Infections such as strep throat or bron-chitis.

• Certain medications such as lithium, indomethacin, propranolol, quinidine, and antimalarials.(12)

• Skin injury (known as the Koebner phe-nomenon; psoriatic lesions form in unin-volved skin after cutaneous trauma).(22)

Treatment To date, there is no known cure for psoria-sis. Current focus is on management of symptoms and reducing the risk of comor-bidities. Poor long-term adherence is a common issue in psoriasis management and may be attributed to complicated

TABLE 6 - Pharmacological Treatments for Psoriasis According to Severity(16)

Psoriasis Type Treatment Examples

Mild to moderate psoriasis

• Topical therapy*, such as: - Corticosteroids (hydrocortisone, betamethasone) - Coal tar - Anthralin- Vitamin D derivatives (calcipotriol, calcitriol)- Tazarotene- Salicylic acid

*Topical therapies may be used alone or in combination. Choice is often dependent on body site involved

Moderate psoriasis • Topical therapy + UV phototherapy

Chronic moderate to severe psoriasis

• Intravenous or subcutaneous biologic response modifiers (adalimumab, brodalumab, etanercept, guselkumab)

• Oral immunosuppressives (methotrexate, apremilast)• Oral acitretin

TABLE 5 - Most Common Types of Psoriasis(13)

Type Characteristics Images

Plaque (most common)

Appears as raised, red patches covered with a silvery white buildup of dead skin cells.

Guttate (second most common)

Appears as small, dot-like lesions. Guttate psoriasis often starts in childhood or young adulthood, and can be triggered by a strep infection.

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treatment regimens, inconvenience, and the use of medications that are malodorous or cause staining.(16) Common treatments for psoriasis include topical and systemic therapies (Table 6). Ultraviolet (UV) photo-therapy is also an option for management when topical therapies alone have failed.(17)

RosaceaOften mistaken for adult acne, rosacea is a chronic and progressive vascular skin dis-order that affects over three million Canadians.(18) It is the fifth most common diagnosis made by dermatologists and patients usually present between the ages of 20-40.(19) Signs and symptoms commonly reported with rosacea include facial redness, burning, swelling, skin thickening and stinging. These symptoms affect overall self-esteem and confidence, and may cause patients to avoid social situations. Eye symptoms, such as irritation, dryness and conjunctivitis, can also occur, with 50% of patients being affected.(20) If left untreated, inflammatory bumps and pimples often develop, and in severe cases—particularly in men—the nose may become swollen and bumpy from excess tissue.(20)

Causes of RosaceaThe exact cause of rosacea is unknown, but genetic and environmental factors are likely involved. Recent studies have shown that the facial redness is likely to be the start of an inflammatory continuum initi-ated by neurovascular dysregulation and the innate immune system. A microscopic mite called Demodex folliculorum has also been implicated. This mite is a normal inhabitant of human skin, but is substan-tially more abundant in the facial skin of rosacea patients.(20) Four types of rosacea have been defined by the National Rosacea Society; please refer to Table 7.

Treatment Untreated rosacea can worsen over time, so it is important that patients see a physi-cian as soon as possible. Treatment adher-ence is critical, as discontinuation of ther-apy can result in the resurgence of rosacea symptoms.(21) Engaging in regular conver-sations with patients to ensure they under-stand this may facilitate adherence. Treatment includes both nonpharmacologic

strategies (below) and pharmacologic therapy (Table 8).

Nonpharmacologic treatments• Educate patients on rosacea triggers and

lifestyle factors, such as sun exposure, stress and alcohol, which can worsen the condition.

• Encourage regular use of a broad- spectrum, high SPF (30 or above) sun-screen to help prevent rosacea flare-ups.

• Provide skincare tips, such as avoiding products with astringents or fragrances, which might cause further irritation.

• Avoid certain foods that may cause flush-ing, such as hot drinks and spicy foods.

• Use green-tinted foundation to reduce redness.

• Undergo treatment with vascular lasering systems or broadband intense light for management of certain phenotypes.

• Use eyelid hygiene measures (e.g., gently washing eyelids BID with warm water and diluted baby shampoo) if there is ocular involvement.

Role of the Pharmacy Technician in Dermatological Care Pharmacy technicians (RPhTs) can play a pivotal role in the circle of care for patients with dermatological conditions. If the patient is new to the pharmacy, gathering lifestyle information (e.g., smoking status, diet, exercise) and a best possible medica-tion history (BPMH) can assist in identifying potential disease triggers. For example, in the case of psoriasis, if it is identified that the patient smokes cigarettes, a discussion on smoking cessation could follow, where the RPhT explains how the pharmacist can assist in quitting and how quitting may reduce disease severity. Since obesity is

TABLE 7 - Types of Rosacea(18)

TABLE 8 - Pharmacological Treatments for Rosacea(19)

Type Characteristics

Erythematotelangiectatic Rosacea sufferers often experience flushing and persistent facial redness. Small blood vessels may also become visible in some patients, and stinging, burning, swelling and roughness or scaling may occur.

Papulopustular In addition to persistent redness, bumps (papules) and/or pimples (pustules) are common in many rosacea sufferers. Some patients may also experience raised red patches known as plaques.

Phymatous In some individuals, rosacea may affect oil glands and connective tissue causing skin tissue to thicken (appearing enlarged) and become bumpy. Phymatous rosacea most commonly affects the nose.

Ocular In addition to skin symptoms, rosacea may affect the eyes and eyelids. It can cause redness in skin tissue surrounding the eyes, ocular burning or stinging, dryness, light sensitivity, blurred vision and watery, bloodshot eyes.

Rosacea Type Medication Examples

Erythematotelangiectatic • Topical therapies (brimonidine)

Papulopustular • Topical therapies (metronidazole, azelaic acid, ivermectin)• Oral antibiotic therapy (doxycycline, tetracycline)• Low-dose isotretinoin

Phymatous • Oral therapy (low-dose isotretinoin)• Oral antibiotic therapy (doxycycline, tetracycline)• Topical retinoids

Ocular • Topical therapies (cyclosporine eye drops, artificial tears)• Oral antibiotic therapy (doxycycline, tetracycline)

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Please select the best answer for each question and answer online at eCortex.ca for instant results.

QUESTIONS

1. Which type of rosacea commonly affects the nose?

a) Ocularb) Papulopustularc) Phymatousd) Erythematotelangiectatic

2. Which of the following skin conditions is most commonly seen by dermatologists?

a) Psoriasis b) Rosaceac) Acne d) Eczema

3. How many Canadians are affected by psoriasis?

a) 5 million b) 1 millionc) 20% d) 5%

4. Which of the following is a known cause of eczema?

a) Geneticsb) Contact with an environmental irritantc) Stressd) All of the above

5. Which condition commonly begins in early childhood?

a) Rosaceab) Acnec) Psoriasisd) Eczema

6. How can a pharmacy technician assist a patient with a dermatological condition?

a) Demonstrate how to apply topical medication

also linked to psoriasis severity, a RPhT could gather information related to diet and exercise to assist the pharmacist in coun-selling the patient.

Discussing insurance coverage with the patient may also be critical, as some treat-ments can be costly. If a patient is struggling to afford their medications, adherence can be negatively affected. Using less medica-tion and/or using the medication less fre-quently than prescribed (e.g., applying a topical product once daily instead of twice daily) to make it last longer may reduce product efficacy. Such non-adherence, or discontinuation of treatment, can potentially be avoided if RPhTs monitor patients’ refills, and continue conversations regarding the importance of adherence for successful dis-ease management. If cost becomes an issue, the RPhT could ask the pharmacist to intervene and potentially recommend a cheaper alternative for the patient.

RPhTs can ensure moisturizers are always in stock and readily available to newly diagnosed patients and those con-tinuing treatment. Inventory issues can dis-rupt skincare regimens, potentially causing a disease flare-up.

RPhTs can also help organize in-house patient education sessions. These sessions would allow patients to interact with other individuals with similar dermatological con-ditions, reinforce appropriate medication administration and the importance of adherence, and provide an opportunity for patients to ask questions. Inviting different practitioners (dermatologist, dietician, nurse practitioner) to speak can assist patients in identifying important care pro-

viders who can help them manage their condition, and understand how different professions work together to provide com-prehensive and quality care.

At each refill, RPhTs can play an import-ant role in identifying patients that might need referral to the pharmacist. Asking open-ended questions, such as “what questions or concerns do you have about this medication?” and “how do you take/use this medication?” can reveal adverse effects or medication administration difficulties that can be addressed by the pharmacist.

By understanding common dermatolog-ical conditions and their treatments, RPhTs can help facilitate the successful manage-ment of these conditions, improving health outcomes and quality of life for patients.

REFERENCES1. Canadian Dermatology Association. Acne. https://dermatology.ca/public-patients/skin/acne/ (accessed January 7, 2020). 2. CMAJ Group, Management of acne: Canadian clinical practice guideline. CMAJ 2016;188:118-26. https://www.cmaj.ca/content/188/2/118 (accessed January 7, 2020).3. Beleznay K. Acne. Compendium of therapeutic choices. Toronto, Ontario: Canadian Pharmacists Association; 20194. Choi YS, Suh HS, Yoon MY, et al. A study of the efficacy of cleansers for acne vulgaris. 2010 https://www.ncbi.nlm.nih.gov/pubmed/20394494 (Accessed Jan 21. 2020)5. Canadian Dermatology Association. Eczema. https://dermatology.ca/public-patients/skin/eczema/ (accessed December 23, 2019).6. Weinstein M. Atopic dermatitis. Compendium of therapeutic choices. Toronto, Ontario: Canadian Pharmacists Association; 2019.7. Sihota, A. Atopic, Contact, and Stasis Dermatitis. Compendium of Minor Ailments. Toronto, Ontario: Canadian Pharmacists Association; 2018.8. National Eczema Association. Bleach bath recipe card. https://nationaleczema.org/wp-content/uploads/2018/03/FactSheet_BleachBath_FINAL.pdf (accessed January 20, 2020)9. National Eczema Association. Eczema facts. https://nationaleczema.org/research/eczema- facts/

(accessed January 5, 2020).10. National Eczema Association. Eczema and Bathing. https://nationaleczema.org/eczema/treatment/bathing/ (accessed January 21, 2020)11. Patrizi A, Raone B, Ravaio G. Management of atopic dermatitis: safety and efficacy of phototherapy. Clin Cosmet Investig Dermatol 2015;8:511-20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599569/ (accessed January 14, 2020).12. Canadian Dermatology Association. Psoriasis. https://dermatology.ca/public-patients/skin/psoriasis/ (accessed December 20, 2019).13. National Psoriasis Foundation. Psoriasis fact sheet. https://www.psoriasis.org/sites/default/files/psoriasis_fact_sheet_0.pdf#utm_source=EduPageCP (accessed December 20, 2019).14. National Psoriasis Foundation. Comorbidities associated with psoriatic disease. https://www.psoriasis.org/about-psoriasis/related-conditions (accessed December 20, 2019).15. National Psoriasis Foundation. Causes and triggers. https://www.psoriasis.org/about-psoriasis/causes (Accessed December 20, 2019).16. Langley R. Psoriasis. Compendium of therapeutic choices. Toronto, Ontario: Canadian Pharmacists Association; 201917. National Center for Biotechnology Information. Does light therapy (phototherapy) help reduce psoriasis symptoms? May 18, 2017. https://www.ncbi.nlm.nih.gov/books/NBK435696/ (accessed January 8, 2020).18. Canadian Dermatology Association. Rosacea. https://dermatology.ca/public-patients/skin/rosacea/ (accessed January 5, 2019).19. Rivers J. Rosacea. Compendium of Therapeutic Choices. Toronto, Ontario: Canadian Pharmacists Association; 2019.20. National Rosacea Society. Understanding rosacea. https://www.rosacea.org/patients/materials/understanding-rosacea-brochure (accessed January 5, 2020).21. Wolf JE. Medication adherence: a key factor in effective management of rosacea. Adv Therapy 2001;18: 272. https://link.springer.com/article/10.1007%2FBF02850197 (accessed January 8, 2020).22. Sagi L1, Trau H. The Koebner phenomenon. Pubmed 2011 Mar-Apr;29(2):231-6. doi: 10.1016/j.clindermatol.2010.09.014 (accessed January 31, 2020).23. Sihota, Acne. Compendium of Minor Ailments. Toronto, Ontario: Canadian Pharmacists Association; 2018.24. Chopra, R Vakharia, PP Sacotte, R Silverberg JI. Efficacy of bleach baths in reducing severity of atopic dermatitis: A systematic review and meta-analysis. 2017 Nov;119(5):435-440. doi: 10.1016/j.anai.2017.08.289. (Accessed February 1, 2020)

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b) Take a best possible medication historyc) Change a topical medication from a cream

to an ointmentd) Communicate with the prescriber about

the best treatment care plan for the patient.

7. What is another name for eczema?a) atypical dermatitisb) atopy dermatitisc) allergic dermatitisd) atopic dermatitis

8. Which of the following is recommended to prevent rosacea flare-ups?

a) Using a sunscreen with an SPF of 30 or higher

b) Using a sunscreen with an SPF of 60 or higher

c) Using astringentsd) Using corticosteroids

9. In patients with eczema, bathing should be limited to which of the following durations?

a) 1–2 minutes

b) 20 minutesc) 5–10 minutesd) 30 minutes

10. Biologic response modifiers are used for treatment of which condition?

a) Acne b) Rosacea and psoriasisc) Psoriasis and eczemad) Eczema

11. In this article, scarring was discussed as a potential outcome for which of the following conditions?

a) Acneb) Rosaceac) Psoriasisd) Eczema

12. Which is not a comorbidity commonly seen with psoriasis?

a) Depressionb) Obesityc) Kidney diseased) Liver disease

13. How long may it take for improvement to be seen with acne treatment?

a) 3–6 monthsb) Immediately after starting treatmentc) 2–3 monthsd) 6 months or longer

14. Which of the following conditions can be treated with phototherapy?

a) Acne and psoriasisb) Psoriasis and eczemac) Rosacea and acned) Eczema and acne

15. Which of the following conditions can be treated with isotretinoin?

a) Psoriasis and acneb) Rosacea and eczemac) Eczema and psoriasisd) Acne and rosacea

For information about CE marking, please email canadianhealthcarenetwork@halldata.com. All other inquiries about Tech Talk CE should be directed to Vicki Wood at 437-889-0615, ext. 1254 or vwood@ensembleiq.com.

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Please consult this course online at eCortex.ca  for specific expiry dates. 

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